Abstract

Midline destructive syndrome (MDS) is a clinical of diverse etiology that may appear in immunocompromised and immunocompetent subjects. The purpose of the present work is to describe the case of a 68-year-old man with human immunodeficiency virus infection and CD4 lymphocytes with 666 cells, type 2 diabetes mellitus and well metabolic control. He began 3 months earlier pain and increased volume in the palate and left maxillary region and non-painful bilateral submandibular adenopathies, fever, unexplained weight loss and night sweats. A CT scan showed a tumor lesion at the level of the lower jaw with extension towards the nasopharynx. Serology for Epstein Barr was negative. Histopathological finding study with immunohistochemistry demonstrated diffuse large B-cell lymphoma with colonization by hyphae. This case highlights the need for a comprehensive and systematic approach to this pathology, for which we propose a stepwise approach.